Individual
MS. ANISA MEGHAN JALLAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10590 N MERIDIAN ST STE 105, CARMEL, IN 46290-1028
(317) 583-7800
Mailing address
10590 N MERIDIAN ST STE 105, CARMEL, IN 46290-1028
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10004387A
IN
363AM0700X
Medical Physician Assistant
1167615
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104500300
—
FL
Enumeration date
09/22/2019
Last updated
06/06/2024
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